HomeMy WebLinkAbout954 JUNIPERO DR - Building Permitsaooaess: g54 JUNIPERO DR
n�sHaMe: MR. WINFIELD _
noowess: SAME
RflCH1ENGINEEfl:
RODflESS:
flEG.NO.:
uNiT:NONE , CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 044838 PLAN CHECK NO: N
UNR:
PEHMITTEE: CAL PAC ROOFING ( 71.4 ) 583-0884
►DOHESS: 9z'�2 JERONIMO -
IRVINE CA 9 718
LICENSED CONTIIRCTOB DECLAMTION: I hereby aifirm Ihat I am Iicense0 un0 vlsio a� ChaO�e� 9lcommencinp vnth SettiOn
7000) ol DiNsion 3 0l I�e Buslness an0 Pmfessions Cotle, d y license is i ull i ce a eHect. .
CITY L C.:� Q Q 2 j}� STRTE L1C.:S 1 Z B 6 ' $� C— 9,
oa�e: i � � °� �� � SiAnaN :
� _.
WOBHEBS' COMPENSRTION OECLAMTION: I herehy ' ihat I have a certiLcate consent ta self-i ra or a certificate oI Workers'
Compensation Insurance, or a certifieJ copy ihereof (Section 3800, La�. C).
roucvxo.: O1WCP].2072A E%P.ORTE: O9 /O1 /9O
caMrnNr: SUPERIOR NATL,
`1 CertifieA copy is h,��e�reb�y ---f--u,,,m...ished. � Certified copy is i ith �he ciry Bu' nA vision. �
aate: ����. _ NPDlicant: V""'� � �
E%EMVfION FXOM WOBNEBS' COMPEN&1TION �ECUIUTION: �Tliis seNon need not be compkt , if ihe permit is for o e hunOreO (E700) or leu).
I certiry that in ihe padarmance af ihe work for which Nis permit is issueA, I shall no[ emplo any person in any manner so as to Uecome
suhlect ro Ihe Workers' Campensation Laws oi California.
Da�e: SignaWre:
NOTICE: It, atter makinq Ihis declaration, yau s�oultl hecome su6lect ro the Workers' Compensalion provisions of Ne Labar
CoOe, you must forthmtA comply wit� such provisions or this Dermfl�s�all 6e AeemeO revoke0. .
CONSTNUCTION LFNOINC RGENLY: I`�ere6y aifirm that Ihere is a constmction lentlinp apency for the petlormance of Ihe work tor
wtiich Ihis Oe�mit is issue0 (Seciion 3W7, Civ: C�. ' ,
IFNDER:
RDORFSS: ', ' '
aWNEB BUILOER OECIAMTiON: I hereby affirm ihat I am exempt imm Ihe Contractors' State License Law for tAe followln0 reason
(Section 7031.5 Busineu and Professional CoEe: My ciry af counry which requires a permit ro constmct, alter, impmve, Eemolish, or
repair any stmcture, D�or ro its issuanu, also requires the aDP��ant far suc� permit to file a sipnetl statement �hat he/s�a is licensetl
pursuant to the provisions ol IAe Contraciors' State License Law (C�apter 9(wmmencinq wit� Section 7000) af DiNsion 3 0l che Business
an0 Pmiessians Cotle) or ttut he/sAe ¢ exem0� lheretrom an0 the Uasis for the alle0e0 exemption. My violation of Section 7031 S Gy
any applicant far a permtt sublects Ihe aDPlicant to a civil penalry ai not more than tive hunaretl tlollars (5500�.
I, as owner ol Ihe pmperty or my emVloyees with waAes as�tAeir sole compensaqon, will Uo t�e waM, antl Iha
❑ strucwm is nat imenaed or ofleaA far sale (Section 70dA, Business and Pmfessional Catle: T�e COMractars' Slate License Law
tloes no� aOPly ro an owner oi a proDeM w� builds or�impmves Ihereon, anA wha Oaes such work himself/hersell or IhrouAh
�is or Aer own employees, pmviAeA that such improvements are na[ intentleE or otlereU lor sale. Ii, �owever tAe Ouiltlinp or
impwvement is sa10 within one year oi completian, t�e owner vnll have t�e burAen oi Oravinq �e/sAe Eid nat builtl or improve
br Ine Ouryose ot sale�. '" .' ' .
- I, as owner ai ihe OroOenY, am exclusively coniracting with licensed contrictors ta constmct t�e pmject (Section 7044, Business
❑ an0 Pmiessions CoOe: The Coniractars' State Licenu Law tices not apply to an owner ol pmperry wAo hmlAs or improves thereon
' anU who contractsior suc� Orolects with a coniradoqs�license Oursuant ro the Conirectors' State License Law�.l am aware
t�at proot of their Worker's Compensabon.insurance shoNU be Drovitled to me1 '
� I am eKempt untler Section: . e. & P. C. ' . '
/or this reasan: , � '
Dale: Ownec - '
I tlo AereDy certity tAat I am aware of and understantl ihe requiremenis of Calitomia Health anA Safety Cotle Sections 25505, 25533, antl
25534 antl t�at I or any future 6uilding occupant will/will not (circle one) nee0 to comply with said state codes anU Ihe requirements for a
permit br constmction or modi/ication fmm the Nr �ualiry Manapement Disinct. Flesidential conslmclion aDDlicaiions are eaemD� �mm
these provisions. '
Date: ADPlicanc
I here0y certity tAat I �ave rea0 tAis ap0�ication anA state I�at the a6 ve informa�ion is � rrect. A�ee ro ca iply witA all ci�
or0inances anA state Wws relatinA �o buildinA consiruction a e6y Ihoris re0rese aiives of Ih ciry to en er upon tAe a�a
pmOeM �orinSDection purposes. I I
Oate: 1�1 1 .Q � Signat
oriver's �icenu or sociai Secudry x: �
1601i6 W�i�e-BuilEing; Green—Cotle Enla¢ement; Canary—Applicenl: Pink—Revanue: GolEenroE—Assessor
�PERM NO: B � 044II�8
GOVT; N SUPP: N'
CONSTRUCTION TYPE: ' PERMIT TYPE: STR PURPOSE: NEW
JOB DESCRIPTION : RE—ROOF OVER EXISTING � SQ FT: 6,800
CLAIM VALUE: 6,800.00 CALC—VALUE:, [ 6,800.00 GROUP OCC: R—J /
COMMENTS: DECRATILE O/ MED, SHAKE ICBOp3409 L._"'"__f� "'�"' (�Q�Iry�,B�/���8 .
it�tftit+t+t+�it**+��t*+�i�+t�t�t�t*�tft�t*�r*fr*****f��t**+tir*�r*�rx��t�tx��t�tr3t�t�tit �e�t�t *�r*ir�vex�*�t�tit*�rt+t* iP7� *
Z O N I N G R E Q U I R F. M E N T S �'
S E T B A C K S ,,
------------ MAIN HUILDING ---------�— ------- — ACCESSORY HUILDING --------
FRNT: FT IN REAR; FT ZN FRNT; FT • IN REAR; FT IN
LEFT: F•T IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQUIRED: PARKING PROVIDED; PARCEL; 14172102 ZONE:
PLANNING NOTES>
� • .
ik ik 16 iE if iE iE iE iE 3t 1k 9t iF �F 1f iF iF iE if if if iF if iE iF 1E ik iE iE ik iF 1E iE iE 1E i! if if 1E N� iE if if 1E 1E iE if iE 3E iE iE if iE i! iFif ik iE iE iF 3F ik Ik ik IE iF IF �F iE if 1F iE iE iE iF Ik iF 1F iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : ` DATE:
APPLICATION ISSUED BY; T C {/�y DATE: � I �G � �.
iEifiFlFiFiFiFiFi4ififiEiFiFifiEiEiFifiFiFK 7FiF�7F iFifififif�iEiFifiEiE 3f .
iFlEiEiEiFiEkifiEiEiFiEkikiFifiEiElkkkififiFififiEiEiEiEifikibiFifif�ElEiE3ElEit3EifikiFfE3EiElEiE3fiF3EiEiE�kifiFlkiFiflklPlFiElEM�iEKiEiElEifif�EiEiEiE '
LEGALIZP:TION:N F E E S U M M A R'Y STRUCTURAL',SEGMCNT:Y "
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 90..00 �. ' .50 ,
SMIP/NON—RES
PLAN
ISSUE FEE
HUILDING-•DIV—> PERMIT ISSUE PLAN—CHECK � TOTAL � PAID DOE
TOTALS—=--> 90.50 0.00 0.00 � 90.50 90.50 •.00
REVENUE DIVISION TOTALS--> COLLECTED: �90.50 OVER/SHORT: 00
BLD90P00 pLUMHING ELECTRIC MECHANIC FI E SMIP/TST� GRADING PLAN—CHECK
fFlE iE �E 3f if if dF iF iF iE jE iF iFlE if iE 1E fE iE iE it ik fE iE fF iF iFk iE if iE if fklf ik if iF if iE 3f iE iE iE iE k iE iF if iE iE iE 3f iE iE iF iE iE k 1E iE if M�E 1F iF ik 3E iE if i6 if �E iF 1E iF 3f iF if
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT CUST TOTAL COST
SFR 6800. REROOF BY VALUE RESSDENIAL NOZONE 1.00 6,f300.Q0
END OF FEES
N
:�� L'��" '� � (�(g -r n ,�
�:�I: i��r��r�5� l'y'�4. . -.
CONSTRUCTION AND PLANNING POOL .PA
APPROVALS Permit # ' Date Inspector p�ppROVALS Permit # Date Inspector
i. Temporary Electrical Serviceor Pole::� 52. Pool & Equipment Location
<�-i
Z: _Soil Pipe-Undrgrnd;_ `_ �'� 53. Steel Reinforcement '
�' 3.-Electrical Conduit�Utility-Undrgrnd�� 54. Forms -
"�3.. Electrical Cond'ui{-l7ndrgrnd. � A 55. Electrical Bonding "�
�'S. Steel Reinforceme�t "L�4== 56. Rough Plumbing & Pressure Test �
- c..
�u 57. APPROVALTOCOVER�GUNITE '�
r=:8� Electrical UFER�Grnd. � .
T. 7. Footings i-: o ; 58. Electrical Conduit-Undrgrnd. .
� -
r 8. Foundation "' � _. � 59. Gas Pipe, � Undrgrnd., Tes[
' 9. Water Pipe-Undrgrnd. - ' ' 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Struttural Floor System � � 61. APPROVAL TO DECK ,,
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �
e
12. Sewer Cap -'-� _ �_, ' -' 63. Heater & Vent-Final
13. Roof Drains - --� 64. Plumbing System � Final �
74. Rough Plumbi4g ' 65. Electrical-Finai __.
15. Rough Electrical-Conduit �'. � 66. Solar System-Final '
16. Rough Electric.Wiring ' 67. Fencing & Access Approval
�.77. Rough Wiring Sign 68. APPROVED FOR PLASTERING '
18. Rough Electriw!-T Bar Ceiling 69. POOI/SPA SYSTEMS FINAL
19yRough �eating &.Air Conditioning _ .�, �� =* ,. y �.FIRE DEPT. REQUIREMENT �� �
.. � � ., i �. . �_ ..: � m .. f*n � C ` :� K Y' :'+ '
20`-�Rough Factnr',y Fireplace -; � ;, �. c';:.k 'APPROVALStr;!-Per,mit#
r�1 �.(,, e' 1�1Y-1v(' Y� Y'1
� � ' � 1� � � �h� ^ �
21 _Dut`fs, irj Structuie�: "' �� � r r, 1� M 70. Undergr0und Hydro x
22=Ducts, Venti{ating,t �„ x p s j �+ s. �.7�, productcRiping OG,as �Oil
23 Gas'Pipe_Rough &. Kest ��, �,` "j ��+ � � '�� ': �7y. Undergroand Flu`sh'v ;' y �
G
24.�Roo-f Framing ,- a: '�r ,: ^ -,<x '73�,Undergrnd.StorageiTank•OGas ❑Oil
25...RoofSheathing r�" a �`� '' ` 7%'•'��^'' 7q�•0'verheadHydro'�.^
�--� ,-a x `7 f; ��"K c
- �: -('--� ^ .f \- ' :r A. r.. . '. A• " �n,
26.2T-Ba'r Ceiling (St%uctural) &'Monocoat M.� .. r�i. � 75'ZDry Chemical c,-," x
27-Frameand Flashing� "�FS �•� =� N'k * 76. Dry Standpipe `"=' * �
- r.• :"1 a: M 'N:F v� C�-- "� (i
- ti G: q: .`•: ..g ,* -. "_" _]:: •_
�28.�Lathinq$ Siding , �G� �k • 77 ; FIXED SVSTEM�PJNAL• -. .
..I �' .t'
_
29. Insulation o;_':,'��, � � y` � ;(.: �y � 7$?FIRE PREV. FI(,VAt �' �'
^30. Drywall-Nailing �,� � � w - ; _ � r x �HE�ALTH-DEPT�: REQUIREMENT
'-;31. Plaster Brow� Co`at� � ^� r � ' ��; * "79. FINAL If3SPECTION � -
c.32:�Electrical PoweriMeter�Fjnal '" ,'',' ' � �,�.� �; ^80[7FOOD CERTIFfGAi'E ISSU,ED,... G
=33 =Firia7 Electric� �- r. 67 �: a' . • i �.• ,� �k No4es: ""� '"=�" "' = - `;�'
-f n• c^ r1l :^' u�. 'l I c: ^'.^1 W.
r.34:_Final He`ating:& Ai�.Conditioning' '� � � � �: x . -• ',.„}� * s -�''j'
� 35"Final Gas Pipe-Testr :, - " - .' '�" � - _. =o �� .�.:- -�="
�. � • , r � - r, n C
=36.�Hood or CanoPY'x. �� �� '. i: . i ,k?. � ^ 'io �- - _±
�, .: n � >: r. . �
='37 Final Factory F.iwplace` rr-� r� � � �* I= T�
. v^ i n,l �G' f^ R
.-38. Final Plumbin / �-�' i.� !: � ; •� x _ 5 r- x � ^
9 . x�- r � Y: : :-� � c<
`39. Water Servi�,Finat� g <• ; � • �P � �^ � � y� '
4 v r+� K +
;40. GasService-Fina1�4T -� '0�' � � �' �' I , x"' �f' f' `}� ry
• a• • f- c. .� ; : r - • o £ >: r
��' ..�, J i ,.
:.41. Solar pomesticFinal �,; ;+� .�: � ' � �. +: r- .,J t^ •t . _•
r r I i� z� �
42^BackflowPreventer.'. ' . ,. � , .. �' �^ �'` . " -
t J u-a' : J �_. �: � r:{: � 'n i V :Y. � ..
'/: IML�I ' �
43. Backflow irrigation. ;-� _ 'r. t. x .. '_ ��� �� �
. t x -a r .
�44.,�LandscapeliripatidnSystem�an yr'� � � ��y x j �" �: ;� ?s y:� C'
`45;Sound ;Attenuation - �• � � { r c ^�:'� ; _ �:v i-�c' -'
�
�46.'�Handicap Regulations "" �{. ~ .` •_ ` c = :
S '� i ,'� ,ti�
-47`"FIN:4L STRUC�iURE & BUILDING,� t� � t � � n
- , -, �l: � ir n
48.�FINAL PLANNr'G ' ''"' / � T `' �' � .: 4� -:
�'=.N � Cd �:: ^':
:;49.:.Elec'tric=Release�to;Edison � � ' � �" - •
r;.:. r. � �: : :, � • C' �:
='50:SGas=Release to So'uthem Califor,'rili Gas Co ;. ! Y `y" " �' �' C', - � � `� -
a ..�. ni4: � S _�C �!i , f'
��51. CERTIFICATE OF OCCUPANCY ' '' "' "" ` ` `
No. � Date
'
AOO���ant to fill in all spates except those
CITV OF COSTAMC/E,� s,4 C—O{NSTRUCTION nPERMIT
ProjectAddress �✓� J�uK%��PK� L%{' .
ApplicanYs Mailing Address 3 oaa �i�R'1�j3�Ai (.�N Y'if'/tl (
i
Owner'sName ����JFIPLcO .SC,Q%%� Phone��yr0
Address ��mQ p'S renTltT L1r/q�•C7K
ArchlEng. License No.
Address
Contractor's Name � Phone�%' V'�'�,
Address Imailing) �22 /� �'�Qsy�e'�//i"� G✓l4Y �/1%/
1
Ciry License No.
LICENSED CONTRACTOR D C ARATION
I hereby aftirm tnat I am licensetl untler provisionz of Charter 9(commenUn9
with section 7000) ot Division 3 of [he Business antl Professlons Cotle, antl
my Ilcense is in � I Izorpe antl effect. /1����
Licensenc�a�;� �� P ^ � L,.ice�e No. Z
Date��— c'onat r A� ff
WORKERS' COMPENSATION D L ION
1 he�eby aHirm tbal 1 have a certifitate o( tonsent to 5¢If-insure Or d C¢rtlflWt¢
'vorkers' Compensation Insurance, or a certifietl copy thereof (Sectlon
), Lab. C.) ✓ ,n' ,[�, A /'
r�ilcy No. �✓G.,x�n�(('� Company����^�^V%reNs]U.�
�Gertilietl copy is hereby fu�nis�etl.
CerCti tl co y is fl,tl wiih the ci[y i i ivisio
Date AOP���ant
EXEMPTION-��RKERS' CO AT DECLARATION
(Thi55eclian neetl nol be completetl if [he per �5 fo� One huntl�etl (5100) or
less).
1 certify thal in lhe performance ot tne wo�k for whiGh thiz perm�t Is Issued, 1
snall not employ any person in any manner so as to Decome subject to the
workerY Compensation Liws of CaliPomia.
Date Signature
NOTICE: If, aiter makin9 this tleclaration, you shoultl become subject to the
Wo�ker5' Compensation provisions Ot the labo� Cotle, you musl forthwi[h
Comply with Su<h 0/ovision5 Or lnls permit snall be tleem¢tl tevOketl.
CONSTRUCTION LENDING HGENCV
I hereby affirm Ihat there is a conztruction IenGin9 a9ency for the periormance
o/ the work tor which this permit is issuetl (Section 3097 Civ. C.)
Lentler's IVame
LenOer's Atltlress
OWNER BUILDER DECLARATION
I hereby affirm lhat I am exempt from the Contractor's Llcense Law tor the
tollowing reason (Saction �031.5 Business antl Professional Cotle: Any ci[y or
county which r¢qWres d pe�mit to Const�uct, altCq Imp�ovB, tlemoli5h or repair
any st�ucture, prlo� to its issuance, also requires the applicant for SUCh pe�mit
t0 tile a signe0 sla�ement that he/she is IirenseC pur5udnt [o the prOvi51on5 of
the ContracroYs Li<ense Law (Gnao�er 9(commencin9 witn SecUon 7000) of
pivision 3 of the Buiiness antl Protes5ions Cotle) or tha[ he/shE I5 exempt
�efrom antl tne basis Por the allegetl exemption. Any violation o/ Sectlon
�,.5 by any applicant fo� a permit subjects tlte applicant lo a Civil
elty of not more than five huntlretl tlollars ($500).
U I, as owner of tne property or my employees with wa9es as thelr sole
mmpensation, wlll tlo the work, antl the ztructure is not intentletl or ofteretl
lor sale (Seccion 7044, Business antl Professional Cotle: The Contractor's
LicenS¢ Law tl0¢5 nol apply to an owner of a property who bulltl5 O� Improve5
th¢r¢On, antl who tloe5 Such w0/k himself/her5elt or Ibrough h15 0� �e� own
employees, prOvitletl lbal zuch improvements are not intentletl or ottorctl for
Sale. H, nowever, the builtling or improvement is soltl wlthin one year ot Com-
pletlon, tne owner will have Ihe bur0en of proving he/Sh¢ tlia not builtl or Im-
prove for the ourposc oi sale).
❑ I, as owner ol the property, am exclusivery contractln9 wlth Ilcensetl con-
l�actorsto consVuc! Ihe Oro�ect ($eclion ]044, Bu5ine55 antl Professions Cotle:
The Contractor's Li<ense Law does not appty ro an owner of property who
builtls or improves lhereon. antl who confracts �or Such oroiects with d r.on-
tractor(s1 Lcense pursuan[ m[ne ConVactor's License Law). I am aware tha[
prOo/ 01 lheir Worker'S Compensatlon insurance shoultl be pwvltl<tl to m!.
❑ I am exempt untler Section B. & P. C. for this reazon
Date Owner
I hereby certify that I have reaC Ihis application and state that tne above
in(ormation is mrrecL I a9ree to comply with all city antl countY ortllnantes
antl stal¢ laws relaling to builtling construction, antl hereby authOrize �ep�e-
Sentatives of I5 city to en[er upon the above-mentiOnetl pioperlyb f/or
InSpaction � ooseji/ __ .if � � /D [ ��A/�
SI9 at �Ii��illv)//
on�e�� �� ss r �
0865�46, rev. 5/88 White - Builtlinq; Canary - APplicant; Pink - Accounting; Goltlenrotl - Assessor
'�..�.W3� I....._..._. ;
TYPE OFCONSTRUC710N NEw �
❑ CONVERSION ❑ DEMOLISH ❑ OT
DESCRIPTION OF WORK/USE OF BLDG. -
bortler Iines antl sign all approD��ate tlaclaratlons.
ALTERATION Ij9 REPAIR
TVPEOFPERMIT LJ GRADING IJ FOUN�ATION LJSTRUCTURAL
❑ TENANT ❑ ELECTRICAL � PLUMBIN,3 ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIP710N Sc]. FT. oCCUCANCv_
CONSTRUCTION TVPE VALUATION 5
ZONE GRADING CU. VDS. ACRES_
Remarks:
$ink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Intereeptors
Kitchen Sink
Lavatories
P—Trep
ROof Drains
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Pipin9
Solar Tank
$wimming Pool w/Spa
Urinal
Water Clout
Water
A.P. ;I�
S Main Buildi
E
T Front
8 Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
FEES P.utometic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher � ,�
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
OuNets
Switches
Garbage Disposal
, Generator �P5 KW C
Reinspection Fee ` $15 I I Issue Fee I $ 3 I
MECHANICAL FEES
Duct- UnderGround
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple �
Firepl/Fact. Blt. iCHO dk
Heating System & Ducting
❑P700,000 BTU �100,OOOBTi
fieinspaction Fee � $15
Hood or Type I ❑
Canopy Typell ❑
Refrigeration System
❑o��ao,aooeTu ❑�oo,000
System Repair/Alteration
Fire Dampers
Registers
luue Fae � $ 3
Fee
2ane
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+ KW
Meter ❑up [0 100 amps
Meter ❑over100amps
Sub Panel
Motors00.7 HP�1Y.-8
Inc. Solar 09-15 HP 016-
Microwave
Pole Light
Range
Si9n
Standing Sections
5 KW Trash Compactor
$75 � � luue Fee
FEES
$ 3
N
1
N
G
R
E
Q
M
T
S.
DEVELOPMENTSERVICESRE�UIREMENTS:
2oning APProved By Date
BuildinB APDroved By Date�-�
Appliption Issued By Dat "1 �1� o"'�
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ � ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL 5 GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �
PLAN CHECK 25% $
Ci 1DD420i1-S7�J42C}11 �'��'.'- ;, i'
Q�:'.�� 09/C5:'�'� TI�IL� j .
CON6TRUCTION />ND PLANNING � POOL 'PA
APPROVALS Permit # Date Inspector AppROVALS Permit # �tey- Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location .
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement " �
,
3.-Electrical Conduit Utility-Undrgrnd. . 54. Forms �
�
4. Electrical Conduit-Undrgrncl. . 55. Electrical Bonding
5. Steel Reinforcement � � 56. Rough Plumbing & Pressure Test '
6.�,Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. �
S.- Foundation . , � �' 59. Gas Pipe, � Undrgrnd., Test �'
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Floor SYstem � 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final
12. Sewer'Cap ' �� 63. Heater & Vent-Final
13. Roof Drains ' 64. Plumbing System - Final - �
14. Rough Plumbing 65. Elecvical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-7 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
�23. Gas Pipe-Rough & Test 72, Und .erground Flush
24. Roof Framing 73. Undeigrnd. Storage Tank � Gas ❑ Oil
25. ���cof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling'{Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: ,
34. Final,Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing �%7 }fQ �.�,
' 39. Water Service-Final _7-jSY L�()
40. Gas Service-Final - �
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation .-
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed �
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co
51. CERTIFICATEOFOCCUPANCY
No. Date
Aop�icant to fill in all soaces except those witnin heavy GorOer Ilnes antl sign all avvropriata tleclarations.
CITV OF COSTA M q� J�`ONSTRUCTION PERMIT
Project Address �J � -��� � Q�'�� �C • .
AppliwnYs Mailing Address CO`/�: mU C' V� T`t.
Owner's Na e�---�I 1 � PhoneS_i.9��D
Address �, 7 J�+-^' f'c� (� � '
Arch/Eng. License No.
Address �� ,.�L'
Contracto�'� Na�+e1p %*�U�S""4- Phone J_O 2(1�i�
Addresslm'I' 1 -Idla .�LC`c,d�t/hc� �J11�w
City License No. �7?� �
LICENSED CONTRACTOR DECLARATI N
I hereby affirm Ihat I am licensetl untler provislons of Charter 9(commencing
with section ]000) ot Division 3 of the Busine55 antl Profe55ions Cotle, antl
my license is In I r e antl eftect.
License Class ��� /��,__� Licenej No.
Date ����.. �3o Signature �����✓� I (��G
WORKERS' COMPENSATION DE ARATION
I hereby atiirm t�at I have a certifitate ot consent to self-insure or a certificate
' Workers' Compensa[ion Insurance, o/ a certifletl copy thereof (Section
]0� Lab. CJ. . {� �Q.�iY�E�
.ulicy No.�1s�-���77-� ComPany S�• i"
Certifietl mpy is hereby furnished.
Cer ified co�p is filetl with the ci[ }i tl�i,n, •D,,ivision/��
Date%/-ai `�' APplican��"-"' L
E%EMPTION FPOM WORKERS' COMPENSATION OECLARATION
(Thissection need not be completetl it the Permit is tor one huntlretl (5300) or
�less).
I certify that in Ihe performance of th¢ wOrk tor whi<h thi5 pe�mi� is issuetl I
shall not employ any person in any mahner so as to become subject to t�e
workers' Compensation Laws of Calitomia.
' Date Si9nature
� NOTICE: It, af[er making this tleclaratlon, You shoultl bemme svbject to thB
' Workers' Compensation orovisions ot thi �bor Cotle, you must forthwith
comply witn such pwvisions or this Permit shall be tleemetl revoketl.
�CONSTRUCTION LENDING AGENCV
I hereby afflrm tnat there is a mnstruction lentling agency for the performance
of tbe work tor whiCh thi5 permit �s i55uetl (Section 309] Civ. C.)
Lentler's Name
Lentler's Atltl�ess
OWNER BUILDER OECLARATION
I hereby atfirm lhat 1 am exempt from Ihe Gontractor's Licens¢ L.aw tor the
following reason (Sectlon 7031.5 Business antl Pro(essional Cotle: Any.city or
county which requires a Oermit to constru�t, alter, improve, tlemolish or repair
any structure, prior to its issuance, also requires the applicant for such permit
to file a signetl statemenf that he/she is licensetl pu�suant to the provisions ot
the Contractor's License �aw (Chapter 9(�ommencing with Section 7000) of
Oivision 3 of tM1e Business antl Profe55i0�5 Cotle) o� that he/She is exempt
'��refrom and the basis for the allegetl ezemption. Any violation ot Section
�,-;:'-A1.5 by any applican[ �or a permit subjects tne applicant to a civil
`,"talty of not more than five huntlretl tlollars ($500).
��� 1, as owner of the p�operty o� my employees with wa905 as thei� sole
compensa[ion, will tlo Ihe work, antl the structure is not intentletl o�-o(teretl
tor sale (Section 7044, Business and Professional Cotle: The Contractor's
License Law tloes not aOP�Y �o an owner Pf a property wito bui1G5 0� imp�ove5
Ihereon, antl who Eoes SUGh wo�k hIm581f/hers¢tl or [hrouqh hIs o� her own
employees, provitletl that such improvements ara not intentletl or otferetl to�
sale. If, however, the bWltling or improvement is soltl within one year oT com-
Dletion, the owner wiil have the burtlen Ot proving he/she tlia not build or Im-
p�ove for the purpose of sale).
❑ I, as owner of the oroperty, am exclJsively contracting with licensetl con-
Irattorsto construct Ihe projecf (Settion 7044, Business antl Pwfe55ion5 Cotle:
The ConVactor's License Law does not apply to an owne� of property who
builtls or improves Ihereon. antl wM10 coMracts fo� such oroiects with a ron-
tractor(s) 1¢ense pursuant to ine ConVaGtor•s License Law). I am aware tnat
{koof of tneir Worker's CompenSatlon insurance zhaultl be provitle0 to me.
❑ I am exempt untler Section B. & P. C. fo� Ihis reason
Date Owner _
1"verebv �erUN that I have reatl this a
or55�F
t
B 3�3�1� � -
TVPE OP CONSTRUCTION NE�
❑ CONVERSION O OEMOLISH
DESCRIPLON OF. WORI</USE QF B
TVPE OF PERMIT LJ GRaol
❑ TENANT" /❑� ELECTRICA
❑ �OTHER �i QJ�(\[�5��
PROJECT DESCRIPTION SQ.FT
CONSTRUCTION TVPE
ZpNE G
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Drinking Fountains
Floor Drains
Floor Sinks
Gas Serviee Outlets
Interceptors
Kicchen Sink
Lavatories
Roof Drains
ADD LI ALTE{3ATION LJ REPAIR
NG LJ FOVNDATION LJ STRUCTURAL
L ❑ PLUMBING ❑ MECHANICAL
VALUATION $
RA�INGCU.YDS. A(
Reinspection Fea � $15
Boiler
Duct-UnderGround
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepVFact. Blt. iCBO #
Heating System & Ducting
❑ 4100,000 BTU � 7 00,000 BT
Reinspection Fee � $15
OB65-46, rev. 5/88 Wbite � Builtling; Canary - Applicanq Pink - Accounting; Goltlenrotl - Assessor
FEES
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Tre'ys
A.P. #
S Main Buildi
E
T Front
B Rear
A
C Right
K
g Left
Ping. Ref. #
Planning Notes:
Accessory 8uilding:
Parking Req./Provided
ELECTRICAL
Automatic Washer Transtormer ❑ 15-50 KW
ConstructionPoleSub. � 50+KW
Cooking Unit Merer ❑up to 100 amps
Dishwasher Meter ❑over100amps
Dryers ❑Gas ❑Electric Sub Panel
Fan Motors D O-1 HP � 1'/: - 8
F.A.U. Inc.Solar �9-15 HP �16-75+
Fixtures Microwave
Device Boxes Pole Light
Outlets Range
Switches Sign
Garbage Disposal Standing Sections
Generator �0-5KW �5-15 KW Trash Compactor. •
Zone
ReinSPection Fee $15 luue Fee �
DEVELOPMENTSERVICESREQUIREMENTS: �
Issue Fee $ 3 Za�inB APProved By
FEES � Building Approved By �
Hood or Typel ❑
Canopy Type 11 ❑
Refrigeretion System
❑aioa,oaoeTu ❑ioo,oao
System Repair/Alteration
Fire Dampers
Registers
laue Fee
$ 3
e
N
1
N
G
R
E
Q
M
T
S.
FEES
$ 3
SUMIY�ARy��EES ,. OS�
BUILDING PERMIT $ _�Q�� SMIP � $
PLAN CHECK $ PERMIT �
PLUMBING $ ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
EI.ECTFiICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ �,,,�����
MECHANICAL $ TOTALFEE $ _��
PLAN CHECK 25% $
Q10Q020321-00020322 TC�T IU8.�7
DATE: !i!?3138 tlfiE: iti:23
/ r ' , _.
CONSTRUCTION ANDPLANNING POOL PA
APPROVALS Permit# Date Inspector AppROVALS Permit# �ate Inspector
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location ",
2. Soil Pipe-Undrgmd. r i' • 53. Steel Reinforcement � '�
3. Electrical Conduit Utility-Undrgrnd: . ' S4. Forms �
4.�Electrical Conduit-Undrgrnd. 55. Electrical 6onding
.5.�Steel;Reinforcement; '� i 56. Rough Plumbing & Pressure Test ,
6.' EI'ect�ical UFER Grnd � 57. APPROVAL TO COVER-GUNITE
' i -.
7.�Footings ' 1` .� '' � 58. ElectricalConduit-Undrgrnd. i
8.: Fountlation � � , � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrn�. 60. Backwash �ines, P-Trap, O Undrgrnd.
10. Structural Floor System , �' 61. APPROVAL TO DECK
11. �Property Sewer Line & House Corinection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final `
73. Roof;Drains 64. Plumbing System - Final
14. Rough Plumbing � 65. Electrical-Final
15. Rough Electrical-Conduii 66. Solar System�Final
1'6. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Hzating $` Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in�Structure 70. Underground Hydro
22. Ducts, Ventilating . 71. Product Piping O Gas ❑ Oil
23. Gas Pipe=Rough & Test 72. Underground Flush
24. Roof Framing � 73. Undergrnd.Storege Tank O Gas O Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar �Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Sicling 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat • 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:�p y 89 �EfP- �y�� �oc�eL^�
34. Final Heating & Air Conditioning �K �
35. Final Gas Pipe-Test •
36. Hood or Canppy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer _ ,
43. Backflow Irrigation � �� �
44. �Landscape Irrigation System .
45. Sound Atte�uation
46. Handicap Regulations � 3�'
47. FINALSTRUCTURE&BUILDING _� _� �J �� '
48. Special Requirements Completed .
49. Electric Release to Edison '
50. Gas Release to Southern California Gas Co ' �� �
51. CERTIFICA7E OF OCCUPANCY !
No, Date
MAR'L 2 t962
OWNER JagES, M. C, p,�'� DATE
dOB ADDRESS oCl� .i,,.,;.,o,.n lb.;,ro _... K l90 BUILI
GENERAL CON'1'HACl'UH pymer-builder VALUE $ 8'ZJy,00 & Cllt do0r
AP No. LOT TRACT 3853 FIR� ZONE DESCRIPTION OF WORKEncl.breezeway,�
INSPECTIONS �Siymnture� DATE GROUP I TYPE p ZONE R-1
Gr_
\ r
r
SUBCONTRACTOR
�����
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX S17 C09TA MEBA. CALIFORNIA
For Appiicanf to Ffll In Comple+ely
TYPE OR PRINT
ADD E'SS � �Y � �J ./Y�-" �-•� G� G
COSTA MESA. GALIFORNIA
/r%, .l_ �-
OWNF_R . f/'ll.fiJFS
MAIL ':�
ADDRESS / .i !� i � = Y= �� �" 1,.-
. TEL. { y
crrr � < <:� � �. %��"3 �).. No. �-�t�y�!
ARCHITECT ��. TEL. —
ADDRESS �j __ _ _
an---
STATE TEL.
LIG NO. NO.
SIZE r_ ./ �. _ I NO. OP BLD68.
� 88TBACK LINC PROM
DESCRIPTION OF WORK
BUILDING !I � NO. �F {
91ZE � � ROOMS / S70RIES �
EXTERIOR WAL�L� ROOF
COVERING .STp(�PD COKERING �X.
1 U$� OF BUILDIlyG ANQWORK TO BE PERFORMFAD
• ' �
1 HeRCBY ACKNOWLHDG2 TXAT NAVE liBAD TH�9 MPLAGTION
AN� 9TATE THAT THE ABOVE �8 CARREGT RND AGR&E TO COH-
PLV WITX ALL QiY ORDINANCEB AN� 9TATE W9 RH6UUTIN6
BUILDIN6 CONBTRU ION. //��
SIGNATURE pF�' ��0, �/i . c O�� , •
PERMITfEF \ [ C� -
F'EE RECEIVED '
dUL 17156f �
FINANCE OEPT.
APPLICATIOt§���I��E�A�� MESA
BUILDING
For Office Use Only
PECEIPT NO. � % PEgp1�T y0.
ev owre rsece�veo ��jAT¢ 1/88'UlD/
ib I 7� /L� // I /��Y.�L i
COSTA MESA. CALIFORNIA
ZONING
r/ I Ho. ov ��f use oR n
vurvs �— � BUILDINa
YARDS EVES
APPROVED ALLO
(CENTHR LINe 6T.) �
TXE AMOUNT 6XOWN UNDER VALUATION IB POR THE
PURP08E OP EBTqBLIBHINa A PENMIT FCE ONLY.
VALUA710N t �0
, PERMIT FEE $ � � N
�
$ (��� PLAN CHECK S '�
�-� rc
iOTAL FEE � • 4
`��? N5
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 977 C08TA MHBA. CALIFORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
AOORE88 954 Juni aro Drive
COSTA MESA CALIFORNIA
■ BTATE
Ci� •
��J - S/�/ TNO.
/� p �� I NO. OF 9LD08.
�( OU��UL�+��, �
�' ��� � �N �i�)
p- aEc ; ����u
�IVAf�C� 0€�fi.
L o r 3S, PGAN�iT3�4����9 '�E�
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
FECEIPT NO. _ FLRN�T_NO.
NECBy� BY I/�pgCHIVPpO II D�T816lU6D
[ 7 G , ,. �ncu
eui�oiNc
ADDRE66 954 Juniaero Drive
COSTA.MESA. CALIFORNIA
FIRE / �% �
20NE TYPE �/ GROUP e-��
APPROVED �
BY DATE
ZONING
ZONH I NO. OF I UBE OF N¢W
D�'1 PLANB /] eUIlDINO W I a�.t ��
�l C. �
Lea�l \p y � �f `-'/ � /� � .
D88CNIPTION � � �Y_y�ti� �/1_�y.}�i! �S Z(�
A. P. NO. IIOIIE
96TBACN LINE PPOM � �� / lC6NTHR
C6NTEx OP 6IHECT d' REAR YARD FRONT
/ �
81DE YARD I LEK'�' RIGHT R. SIDE
DESCRIPTION OF WORK _.__
NO. OF
WORK TO BE
]
.�3
eHEPHBY �i(NOW��48 TMAT 1 HAVH RHAD 1111 MPLIGTION {N6 AMOUNT BXOWN UNDCR VALUAT�ON IB IOR TH!
ANO 6TAT6 THAT TH�BOV� LOR� AND�REe TO COM- pURP098 OP E9TABLIeHIN6 ♦ PeqMIT PEe ONLY.
PLY WITH ALL CIT' O INANCEB AND BTAR LA B pCODUTINO
BUILDINp CONBTF{UR N. VALUATION '1
81GNATURE OF y �. � i o PERMIT FEE $'ly. O L
$ �4, bly•�a
■ AUTHORIZED